There were no ethnic differences in breast cancer screening, whether or not there was a family history.
The researchers didn't know why people in the study did or didn't get screened. But they proposed a few reasons why Latinos might not get their regular colon cancer check-ups, including communication problems with doctors and fear and anxiety about being screened.
"It seems very plausible that this is not happening for Latinos because of access barriers and language barriers," said Heather Orom, who studies racial disparities in cancer at the University at Buffalo and wasn't involved in the new study.
In addition, she added, "we don't know if those messages about family history and risk are resonating culturally with Latinos."
The data came from a 2005 telephone survey of more than 30,000 adults under 65 in California. They were asked how recently they had been screened for breast cancer (with mammography) and colon cancer (with a stool test, sigmoidoscopy, or colonoscopy), as well as whether anyone in their family ever had those cancers.
The researchers, led by Ninez Ponce of the University of California, Los Angeles, used U.S. Preventive Services Task Force (USPSTF) guidelines at the time to determine if participants were getting screened according to recommendations.
That meant mammograms every two years for women starting at age 40, and colon cancer screening every one, five, or 10 years, depending on the method, for men and women 50 and older. (USPSTF guidelines now say breast cancer screening can be delayed until age 50 for average-risk women.)
In total, about 76% of women with no family history of breast cancer and 84% with a family history had been screened for the disease within the recommended window. Latinas with or without a family history of breast cancer were just as likely as white women to report recent screening.
But for colon cancer, it was a different story. Fifty-one percent of all adults with no family history were screened according to guidelines, versus 71% who had a relative with colon cancer.
Compared with average-risk whites, Latinos with no family history of colon cancer were 26% less likely to say they had been screened. And those with a family history were 72% less likely than whites with a family history to get recommended screening.
In the U.S., Hispanics are no more likely than whites to be diagnosed with colon cancer or to die from it. The disease kills about 50,000 people each year nationwide.
"Our troubling finding was that knowledge of their family history of (colon cancer) did not close the Latino-white gap in (colon cancer) screening, but actually widened the disparity," the researchers reported online August 25 in Cancer.
That points to a need for better communication between doctors and Latin patients about family history and cancer risk, they say.
While language and cultural barriers may be keeping screening messages from getting across, Ponce and colleagues explain that some people may also postpone screening because of fear or denial, or underestimate their risk of cancer, even when a family member has been ill.
"There's a gap among people who have a known family history. We believe there's also a gap due to lack of knowledge about family history," Orom added in an interview with Reuters Health.
She said more research is needed to determine what's really behind lower rates of screening in Latinos before any changes can be made to address the disparity.
By Genevra Pittman
Last Updated: 2011-09-15 17:50:16 -0400 (Reuters Health)
Copyright © 2011 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.